| NPI | 1497090914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA MARIE MILLER Dentist Owner Of Corporation 563-556-3468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IA 08466) |
| Enumeration Date | 2012-12-10 |
| Last Update Date | 2012-12-10 |